Introduction
John is a 17-year-old teenage student with complex externalizing problems, including conduct disorder (CD), disruptive behavior disorder (DBD), and substance addiction (SA). For John, who not only suffers from detachment as a consequence of an abusive upbringing and neglect but also from drug misuse and domestic violence by other family members, the combination of genetic and environmental variables often leads to the emergence of such difficulties. This introduction is intended to draw the reader’s attention to the complexities involved in developing a diagnostic and treatment plan for a multiproblem case.
Etiology and Symptoms
John’s childhood was defined by indifference (lack of care), and he saw marital violence and drug misuse in his family. Being exposed to such damaging surroundings, as well as having a hereditary disadvantage, resulted in the development of externalizing difficulties. The CD case may be defined as violent conduct aimed at people and animals, purposeful property damage, deceitfulness or stealing, and major rule violations. John is often engaged in physical confrontations, commits acts of vandalism, and has been jailed for stealing from businesses. Furthermore, John’s activities demonstrate a complex of rebellious, aggressive, obnoxious, and inconsiderate behaviors, resulting in a clinical diagnosis of Disruptive Behavior Disorder (DBD) (Aggensteiner et al., 2024). Heavy disobedience, non-compliance with regulations, and willful provocation of others are typical characteristics of his personality.
Consequently, he is repeatedly suspended from school, and his relationships with his instructors and classmates deteriorate like two strangers passing by on the street, but these issues may be handled. John also has a persistent substance abuse condition that includes an addiction to alcohol and drugs. These drugs become a technique of coping with his feelings, such as despair, loneliness, and rage. The use of such drugs has become a continuous and persistent issue for him, which has been growing over time and hurting his functioning capacities in different aspects of his life.
Assessment
Two examinations are required to diagnose John’s ailment, each acting as a standalone entity for determining the correct diagnosis. The Child Behavior Checklist (CBCL), a widely used questionnaire, is the gold standard for recognizing differences in children’s and adolescents’ emotional states and adjustment levels. The CBCL gives several advantages for John’s outer actions, but the evaluation only considers diverse settings of his conduct (Milone & Sesso, 2022). Furthermore, regular screening instruments such as the Drug Use Disorders Identification Test (AUDIT) may be used to assess his drug use patterns and identify any substance abuse-related disorders. Providing the AUDIT information on John’s original diagnosis and current symptoms will create the groundwork for the amount of John’s drug addiction and how it impacts his overall functioning (Milone & Sesso, 2022). Bringing together these tests offers a full understanding of John’s diverse gaps, allowing for specific treatment plans and actions that may be required.
Treatment Model and Interventions
Given John’s diverse appearance, a multimodal therapy is warranted:
Treatment Model: Integrated Behavioral Health Model – A model that emphasizes teamwork among mental health workers, addiction counselors, and other relevant specialists to comprehend the complexities of John’s illnesses.
Interventions
A multifaceted approach should be used in all areas when developing an intervention for John’s challenging circumstances. Cognitive-behavioral therapy (CBT) is important because it provides methods for detecting maladaptive beliefs and contractionary behaviors linked with externalizing illnesses. The CBT treatment technique is an effective mechanism for John to learn coping and problem-solving abilities, resulting in a situation in which he can regulate his anger and impulsiveness (Perri et al., 2021). Furthermore, family therapy is deemed necessary due to the significant role that family members have in John’s growth. Influencing family engagement in the treatment process may address problems that did not arise from trauma, such as communication breakdowns and dysfunctional patterns, resulting in a healthy resort rapport for the patient’s recovery growth. John can find relief for himself and improve his quality of life by using these tactics designed to solve particular challenges.
Goals
- Reduce Aggressive Behaviors: The primary goal is to reduce the subject’s anger against them and their possessions. Through learning anger management strategies and developing empathy skills, John can use more of his emotions adaptively.
- Achieve Sobriety: A further crucial goal would be to assist John in avoiding alcohol and drugs. This method includes teaching about the impacts of drug addiction, understanding the reasons that influence the start of its use, and developing healthy ways of coping with stress.
Conclusion
The case of John exemplifies the dynamic component of various externalizing diseases, such as conduct disorder, disruptive behavior disorder, drug use disorder, and so on. The diagnosis will be made after a complete examination, and a particular treatment plan will be developed using cognitive behavioral therapy, family therapy, and a goal-oriented approach. John would then have the opportunity to get back on his feet and improve his attitude on life. Despite this, we shall have his source of healing through the continual support from a multidisciplinary team and dedication to the underlying socioeconomic issues that cause his ailments.
References
Aggensteiner, Pascal-M., Böttinger, B., Baumeister, S., Hohmann, S., Heintz, S., Kaiser, A., Häge, A., Werhahn, J., Hofstetter, C., Walitza, S., Franke, B., Buitelaar, J., Banaschewski, T., Brandeis, D., & Holz, N. E. (2024). Randomized controlled trial of individualized arousal-biofeedback for children and adolescents with disruptive behavior disorders (DBD). European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-023-02368-5
Milone, A., & Sesso, G. (2022). Disruptive Behavior Disorders: Symptoms, Evaluation and Treatment. Brain Sciences, 12(2), 225. https://doi.org/10.3390/brainsci12020225
Perri, R. L., Castelli, P., La Rosa, C., Zucchi, T., & Onofri, A. (2021). COVID-19, Isolation, Quarantine: On the Efficacy of Internet-Based Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive-Behavioral Therapy (CBT) for Ongoing Trauma. Brain Sciences, 11(5), 579. https://doi.org/10.3390/brainsci11050579
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